What's WRONG with $25 for a Transfer?

Unless you've been living in a hole somewhere, you've probably seen the pharmacy chains battling it out with each other for "new" business. The promotion is as follows:

1. Transfer your prescription from ANOTHER pharmacy.

2. Get a coupon or gift card worth $25.

This idea started several years ago. I can't even tell you who started it. All I know is it started with this brilliant idea: 

Our competitor has customers that get prescriptions at their store. We want those customers to get their prescriptions from us... but more importantly we want them to shop in OUR store. So let's give them an incentive to bring their business over to our pharmacy by throwing some money at them. 

SO WHAT'S REALLY INVOLVED IN A PRESCRIPTION "TRANSFER" 

Laws vary from state to state, but the general idea is that a "prescription" can only "exist" in one pharmacy at any one time. You take your prescription to your pharmacy. They transcribe it to a digital form and fill your prescription. The medication, instructions, refills, doctor, and patient information are all "housed" at the pharmacy where you filled it, but it is YOUR prescription. If you so choose, you can have all that information transferred to any other pharmacy in the United States depending on the state laws. Controlled substances have special limitations that vary from state to state, but for the most part they can be transferred too.

So let's say you get a common blood pressure medication (Lisinopril 10mg) filled at Goofmart Pharmacy. You decide you want to transfer it to Kame-Apart Pharmacy and take advantage of their transfer coupon. The pharmacist at Kame-Apart calls the pharmacist at Goofmart and gets the information over the phone, verbally. This only takes a few minutes, but of course, the more prescriptions you transfer, the more time it takes. Usually the calling pharmacist has to wait, and wait, and wait... especially if he or she called a Wagmart pharmacy-- they're always busy. This is time that the pharmacist could be doing a crap load of other things that require attention all the time. But you want your coupon, so the pharmacist waits...

Finally the information is transferred and Kame-Apart can now fill the prescription. You pay for and pick up your med then you're handed the $25 coupon. What was simple for you actually required a lot of time and effort for two pharmacists to communicate with each other.

SO WHY DO PHARMACIES DO THIS?

Pharmacies don't make a lot of profit. I know you think we're rolling in the dough, but we're not. The drug companies make the big bucks as do the pharmacy benefit managers. Apparently there's something called "rebates" from drug manufacturers that the pharmacy chain gets down the road, but at the pharmacy level we don't see this profit. Our bonuses (which are few and far between) have nothing to do with these mysterious rebates. Even with the rebates, the actual pharmacy part of the grocery or department store doesn't see a lot of profit, especially when a lot of prescriptions are selling at $4.00 for a month supply thanks to Walmart.

Pharmacies do these coupon deals because they're after repeat business. We throw a little money at you up front hoping you'll shop at our store on a continual basis. At Goofmart there is an actual belief with upper management that if we can just make a good enough impression the customer will come back again and again.

So WHAT's the BIG DEAL?

1. Most people that take advantage of these offers will transfer various medications all over town. When that happens, no one pharmacy knows everything they take. How can the pharmacy provide proper counseling of drug interactions if we don't know the patient's complete medication profile?

2. The pharmacy chain isn't really "earning" a customer. You can't "buy" a customer... you have to "earn" a customer. You do this by providing excellent customer service, proper counseling, getting to know the patient, what they need, their conditions, diseases... etc. 

3. It makes the pharmacy look like carnival barkers, not medication professionals, and those getting the medications are not patients... they're just customers. They're not interested in how we can help them as a pharmacist... they're only interested in the money.

4. MISTAKES happen in transcription over the phone. Sometimes minute details are overlooked which can have consequences with the patient. Here's an example: Propranolol comes in its regular form and an extended release "ER" form. If the pharmacist neglects to mention the "ER," you have a medication error that could cause issues with the patient.

5. Pharmacists and technicians are only human. We have feelings and we work hard to take care of our patients. This type of business model takes that good care completely out of the equation. We become interchangeable cogs in a machine. Moreover, we can't get to know patients that bounce around from pharmacy to pharmacy and important details about patients get lost when they have various prescriptions all over town.

I've been a pharmacist for awhile and I know a lot of pharmacists. Maybe I'm just in the wrong neck of the woods, but I don't know ONE PHARMACIST who likes this business model. It takes precious time to do the TWO transfers (most people end up transferring OUT a month later). We bear the brunt of the risk involved in making a mistake. Moreover, the large majority of people who take advantage of these offers are ONLY after one thing... MONEY. And like it or not, it's really hard not to have an attitude toward these greedy people.

Corporate muckity-mucks will tell you that it's NOT your money and none of your business. They will tell you the promotions work (even though at the store level we're just not seeing it). When we see corporate being stingy with technician hours, it's hard to believe that this business model works. So we get cantankerous, and rightly so. And quite frankly if MY license is on the line every time I risk making a mistake getting or giving a transfer, it damn well IS my business. These are not transfers for grandma who forgot her meds back home... these are transfers for money-grubbers who could care less about my pharmaceutical knowledge or ability to oversee their medication therapy.

After dealing with this load of manure FOR YEARS now, I can count on one hand the number of patients that have stayed at my pharmacy from this program. Over 99% just transfer out their prescription the following month. Given the propensity for errors, this is a huge risk to take to try and yank customers away from their regular pharmacy.